Prevalence and Natural History of Coronary Ostial Aneurysms in Marfan Patients

The aim of this study was to determine the prevalence and natural history of coronary ostial aneurysms in Marfan patients with aortic root replacement.

Thirty-one Marfan patients (mean age, 33.7 ± 11.8 years) who underwent aortic root replacement and postoperative electrocardiogram-gated computed tomographic (CT) angiograms between January 2007 and December 2015 were retrospectively identified. A subset of 15 patients underwent follow-up CT angiograms. Computed tomographic angiograms were postprocessed on 3-dimensional software to measure maximal coronary ostial diameter. Coronary ostial aneurysm was defined as diameter of greater than 10 mm.

Right coronary ostial aneurysms were present in 45.2% (14/31) of patients, and left main coronary ostial aneurysms were present in 51.6% (16/31) of patients. Mean ostial diameter was 10.1 ± 1.9 mm for the right coronary artery and 10.0 ± 1.8 mm for the left coronary artery. In a subset of patients with follow-up CT angiograms, there was no significant change in coronary ostial diameter on follow-up examinations (P > 0.05).

Coronary ostial aneurysms were common in Marfan patients after aortic root replacement. These findings remain stable over time and may have little clinical consequence.